Primordial Sound Meditation Application Form

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Have you ever been instructed in a mantra meditation technique? *

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My decision to learn Primordial Sound Meditation (PSM) is a personal decision. I have not been made any promises or warranties that I will receive any specific results. I understand that the Primordial Sound Meditation technique and practice is not a substitute for treatment or services ordinarily provided by health care professionals for physiological or psychological conditions. I further understand that any instruction given to me during the Primordial Sound Meditation classes is for me personally and may not be appropriate for others.

In consideration for teaching the Primordial Sound Meditation, I hereby agree to hold Regina Santos, D.B.A. Matter by Regina, and their officers, agents, and employees harmless in any claims brought by me, or on my behalf, which contradict the above.

My submission of this form constitutes my acceptance of the conditions expressed in the agreement.

I appreciate your business and thank you for your confidence in my services. If you have any questions, suggestions, comments and such, please let me know so that I can offer you the best program possible!

-Regina Santos

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